Flindris Stefanos, Styliara Effrosyni, Galaziou Georgia, Petousis Stamatios, Margioula-Siarkou Chrysoula, Paschopoulos Minas, Navrozoglou Iordanis
Second Department of Obstetrics and Gynecology, School of Medicine, Aristotle University, Thessaloniki, GRC.
Department of Radiology, University Hospital of Ioannina, Ioannina, GRC.
Cureus. 2025 Aug 6;17(8):e89504. doi: 10.7759/cureus.89504. eCollection 2025 Aug.
A 34-year-old nulligravida with schizophrenia presented after four months of progressive abdominal distension, culminating in severe respiratory compromise. An urgent transabdominal ultrasound was initially interpreted as massive ascites; however, its diagnostic accuracy was limited by the extreme abdominal distension and the patient's inability to change position due to respiratory distress. Further evaluation with CT of the thorax and abdomen revealed a 35 × 42 × 48.5 cm cystic mass arising from the left ovary, causing marked thoracoabdominal compression. Laboratory studies demonstrated leukocytosis, elevated inflammatory markers, and increased carcinoembryonic antigen and carbohydrate antigen 19-9, consistent with an ovarian neoplasm. An urgent midline laparotomy permitted controlled decompression of 37 L of serosanguinous fluid and en bloc resection of the ovarian mass, relieving the patient's respiratory distress. Histopathology identified a mucinous borderline tumor with focal intraepithelial carcinoma, microinvasion (<5 mm), and an incidental benign Brenner component. After an uneventful recovery, the patient elected definitive management and underwent total hysterectomy with right salpingectomy one month later. At six-month follow-up, she remained in good health without evidence of recurrence.
一名34岁未孕且患有精神分裂症的女性患者，在出现进行性腹部膨隆四个月后前来就诊，最终导致严重的呼吸功能不全。最初的急诊经腹超声检查结果被解读为大量腹水；然而，由于极度的腹部膨隆以及患者因呼吸窘迫而无法改变体位，其诊断准确性受到限制。进一步的胸部和腹部CT检查显示，左卵巢有一个大小为35×42×48.5厘米的囊性肿块，导致明显的胸腹受压。实验室检查显示白细胞增多、炎症标志物升高、癌胚抗原和糖类抗原19-9升高，符合卵巢肿瘤表现。急诊中线剖腹探查术使37升血性浆液得到控制性减压，并完整切除卵巢肿块，缓解了患者的呼吸窘迫。组织病理学检查确定为黏液性交界性肿瘤，伴有局灶性上皮内癌、微浸润（<5毫米）以及偶然发现的良性布伦纳成分。在顺利康复后，患者选择了确定性治疗，一个月后接受了全子宫切除术及右侧输卵管切除术。在六个月的随访中，她身体健康，无复发迹象。
